Skin graft: elevate and immobilize graft site to prevent movement and shearing.Mastectomy: HOB elevated at least 30 degrees with affected arm elevated on pillow to promote lymphatic fluid return. Turn client only to the back or unaffected side.

Perineal and vaginal procedures: lithotomy position

Cataract surgery: elevate HOB 30-45 degrees. Turn client on back or non-operative side to prevent edema of site.

Retinal reattachment: obtain dr’s order re: positioning. If gas is used as tamponade, client may have to be specially positioned. Some must lie face down or on the side as prescribed.

Liver biopsy: Right side-lying with pillow or small towel under puncture site for at least 3 hours.

Intestinal tubes: Place client on right side to facilitate passage into duodenum.NG tubes: Elevate HOB 30 degrees to prevent aspiration. Maintain elevation for continuous feeding or 1 hour after intermittent feedings.Rectal enemas/irrigations: Left Sims’ position to allow gravity to work in the natural direction of the colon.

COPD: Sitting position, leaning forward, arms raised on table or pillowsLaryngectomy: semi-Fowler’s or Fowler’s to maintain patent airway and minimize edemaBronchoscopy: semi-Fowler’s to prevent chokingPostural drainage: Lung segment to be drained should be in uppermost position.Thoracentesis: During procedure, position client sitting on edge of bed leaning over bedside table, with feet supported OR lying in bed on unaffected side with HOB elevated 45 degrees.

Laminectomy: log roll client, keeping back straight as can.ICP: Elevate HOB 30-45, maintain head in midline, neutral position. Avoid extreme hip and neck flexion.Lumbar puncture: during, assist to lateral position with back bowed at the edge of exam table, knees flexed up to abdomen, and head bent so chin is resting on chest.After: supine position 4-12 hours (dorsal recumbent)Myelogram: Water-soluble dye – HOB elevated for at least 8 hours to avoid dye irritating meninges.Oil-based dye: flat in bed for 6-8 hours to prevent leakage of CSP.

Positioning Client Post-op:Hip surgerySpinal cord injury

Spinal cord injury: immobilize on spine board, with head in neutral position. Immobilize head with firm padded c-collar. Maintain traction and alignment of head manually. Logroll client. Do not allow client to twist or bend.